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Resource Center

Transition and Coordination of Care

Patient Referrals

Peri-Procedural Management including Bridging

 Anticoagulation bridging decision support
A granular example of a unique power point decision support tool for perioperative bridging which will be embedded into Epic at Dean and St Marys Hospital; includes risk stratification/assessment
 Anticoagulation Task Group Guidelines for Periprocedural Management of Anticoagulants
Includes risk stratification/assessment, warfarin/LMWH bridging, dabigatran, rivaroxaban, antiplatelets, reversal)
 Bridge Worksheet and Patient Calendar
Includes plan and patient instruction sheet
 How I treat anticoagulated patients undergoing elective procedure or surgery (Spyropoulos & Douketis, 2012)
Article from Blood outlining risk, strategy and management as it pertains to patients on anticoagulants
 How to Manage Patients Who Need a Procedure, April 2014
April 2014 Powerpoint by Dr. Robert D.McBane, Division of Cardiology, Mayo Clinic Rochester, how to approach anticoagulation (Warfarin & TSOACs)given published bleeding & thromboembolic event rates
 Perioperative Bridging Guidelines
Includes risk stratification/assessment,warfarin/LMWH bridging, dabigatran,rivaroxaban,antiplatelets)
 Perioperative Guide for Patients on Warfarin, June 2013
3-page guide developed by the VA of California,with bridging recommendations based on bleeding vs. thromboembolic risk;Lisa Tong PharmD, Joyce Lin Pharm D, Tracy Minichiello MD
 Perioperative Guideline
Includes clinician responsibilities,risk stratification/assessment, warfarin/LMWH bridging,dabigatran,antiplatelets)
 Perioperative Management of Antithrombotic Therapy - ACCP Guidelines
PPT presentation, includes bridging principles, risk stratification assessment, case examples
 Perioperative Management of Antithrombotics
Includes risk stratification/assessment, warfarin/LMWH bridging, dabigatran, rivaroxaban, antiplatelets)
 Perioperative management of patients on new oral anticoagulants (Lai June 2014)
Article from British Journal of Surgery outlining anticoagulant interruption strategies for elective and emergency procedures, June 2014
 Periprocedural Guideline
 Progress Note for Peri-Procedure Anticoagulation Management
 Two-Page Summary: Management of Anticoagulation in the Peri-Procedural Period
prepared by IPRO, New York State’s Medicare Quality Improvement Organization (prints best on 11x17 paper)
 Use and outcomes associated with bridging during anticoagulation interruptions in patients with atrial fibrillation, Circulation 2/2015    NEW
Article available on pubmed -- Prospective observational registry assessing use of peri-procedural bridging in AF patients; please also refer to accompanying editorialShaikh AY, McManus DD. A Bridge Too Far? Findings of Bridging Anticoagulation Use and Outcomes in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). Circulation. 2015 Feb 3
 UW Medicine Peri-Procedural Anticoagulation
Risk stratification/assessment, warfarin/LMWH bridging, patient instruction form, specifics for dental procedures)

Transition Between Agents

 Transitioning To & From the Novel Oral Anticoagulants: a Managemenet Strategy for Clinicians (Abo-Salem Feb 2014)
7 page Article from Journal of Thrombosis and Thrombolysis outlining risks during transitions between target-specific oral anticoagulants and different transition scenarios and strategies
 Transitions Among Anticoagulant Medications
5 page table from University of Utah Health Care Trombosis Service providing guidance when transitioning between agents; 4/2013; includes Warfarin, Parenteral Agents, Dabigatran, Rivaroxaban, & Apixaban in simple to easy charts

Transitions Between Patient Care Settings

 Delivery of Optimized Inpatient Anticoagulation Therapy: Consensus Statement from the Anticoagulation Forum, May 2013
From the AC Forum, guidelines designed to promote optimization of patient clinical outcomes while minimizing the risks for potential anticoagulation-related errors and adverse events. Table 8 in the article includes a “Care Transitions Checklist”
 Impact of target-specific oral anticoagulants on transitions of care and outpatient care models
Article by Ann K. Wittkowsky, PharmD, overviews the importance of appropriate transition of care management and provides examples of transition-of-care models and how anticoagulation clinics can and should maintain involvement with the TSOACs.
 Project RED: How to Conduct a Post-Discharge Follow-up Phone Call
Project RED (Re-Engineered Discharge) is an AHRQ/NHLBI-sponsored initiative to improve the hospital discharge process. This document outlines the key components of the post-discharge follow-up call.
 Transitions of Care Between Healthcare Settings Webinar
 Transitions of care in anticoagulated patients (Michota 2013)    NEW
Article from the Journal of Multidisciplinary Healthcare that is outdated for drug therapy information but valuable for its sections on hospital discharge protocols and outlining barriers to safe and effective anticoagulation during care transitions
 Transitions of Care in Patients Receiving Oral Anticoagulants: General Principles, Procedures, and Impact of New Oral Anticoagulants
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